Otoplasty (Ear Pinning)

Like the faces they’re attached to, ears come in all shapes and sizes, some more attractive than others. People can be born with protruding or drooping ears, due to weak or poorly formed cartilage. Trauma such as a dog bite or car accident may also injure the ear. Women’s earrings that are extremely heavy can also affect the attractiveness of the ear.

Over-protruding ears can be a source of distress or embarrassment to both children and adults. Unfortunately they can become the focus of teasing at school leading to feelings of embarrassment and low self esteem that can be long-lasting. An otoplasty procedure (ear pinning, ear re-shaping) addresses cosmetic problems with the ears.

Why do I have prominent ears?

In medicine we refer to prominent ears as “lop ears” and they are actually a group of deformities that result in

the common appearance of a prominent ear. The ear develops during the first trimester from six small swellings on the side of the head. These are visible at 39 days and are called the “hillocks of His”. Something happens during the development of the ear at this early stage that leads to one or a combination of three problems.

1. The overgrowth or protrusion of the conchal cartilage

2. The anti-helical fold does not form adequately

3. A protuberant lobule

These deformities can be inherited and tend to be passed on as autosomal dominant genes.

What surgical techniques are available?

There are in fact more than 200 surgical techniques that have been written to correct the lop ear. The earliest description was back in 1881. In recent years, as with all facial plastic surgery, surgeons have focused on minimally invasive techniques that involve careful place of permanent sutures to re-shape the ear into it’s normal shape and position. This followed the popularity of cartilage cutting techniques that sometimes left the ear with sharp edges and looking unnatural.

When is the ideal time to have prominent ears corrected?

Prominent ears can be corrected at any age. The ideal time is when a young child is 4 to 5 years old. At this age the ears are fully developed but the child has not yet started school where they may be teased. The cartilage is also still very soft and pliable and this lends itself particularly well to suture folding surgical techniques.

Does an otoplasty ever alter hearing?

Although the ears’ folds and convolutions do help hearing by concentrating and localising sound waves, routine surgery will not produce a noticeable change in the ability to hear.

What can I expect during an initial consultation?

At first it is important to discuss any particular concerns that you or your child have about their ears. This is followed by a very careful clinical examination which assesses the various components of the ear to see which ones have formed abnormally and need to be corrected. In most patients there will be an overly prominent conchal bowl and some under-formation of the antihelical fold. Both of these elements will need to be addressed to make the ears look natural.

Clinical photographs are always taken. A detailed discussion about what is involved in correcting your particular ear deformity is then undertaken with information given about the surgery day and post-operative recovery and care.

What to Expect When You Have Ear Surgery

Otoplasty begins with an incision just behind the ear, in the natural fold where the ear is joined to the head. There are usually three key elements that need to be addressed. The first is a change in the position of the ear relative to the skull. The can be addressed through permanent sutures that set the ear closer to the skull. Next the size of the cartilage sitting next to the opening of the ear canal (the conchal bowl) often needs to be slightly reduced in sized. Finally the normal anti-helical fold usually needs to be created. This is done by placing permanent sutures.

Dr Roth prefers the natural results obtained through a cartilage bending or moulding approach and the use of permanent sutures wherever possible.

When the otoplasty is complete, Dr Roth will place a surgical dressing over your ear to help reduce the normal swelling that occurs post-surgery. The bandages are generally removed in a week. Pain after surgery is generally minimal and easily addressed with over-the-counter medication.

When the bandages are removed, you will have a thin white scar behind your ear, which will be almost undetectable.

Most adults return to work about five days following ear surgery while children should wait a week or so to return to school. All patients should temporarily limit their physical activities for about 3 weeks until their ears are completely healed.